Skin Cancer and Reconstruction

Titus Adams performs surgery to remove skin cancers, including Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma (including the  Sentinel Lymph Node Biopsy service at Oxford).  

Patients tend to be referred directly via their GP or Consultant Dermatologists and Tius Adams works as part of the Skin Multidisciplinary team (MDT) where complex or concerning cases are discussed.  

Reconstructive Plastic Surgery is often required as the skin cancers can be extensive or the area for reconstruction is devoid of local skin to aid closure.  Skin flaps or skin grafts are often required to fill the hole or defect once the skin cancer has been removed.

Local Skin Flaps

Skin flaps are employed, particularly on the face, to replace like-for-like skin colour, thickness and texture.  The scars are then designed to hide in the most suitable parts of the face to minimise their appearance which takes place some weeks or months later.  .There are many different designs of flap and their use is dependent on the size of the defect, the type of skin tissue available and the site in which the defect resides.

Skin Grafts

If the defects are much larger, then skin grafts are required.  Their use can be likened to replacing a piece of bad lawn turf with fresh new lawn turf.  Two types of skin graft can be used.  Full thickness skin grafts can be used (typically from spare skin in the neck) or split thickness skin grafts (often taken from the thigh) similar to that used in the treatment of burns.  Both skin grafting techniques have advantages and disadvantages and their use is usually governed by the extent of the defect after the skin cancer is resected.

Titus Adams is currently the Clinical Director for NHS Plastic Surgery Services in Berkshire.  In the NHS, he developed the skin cancer services hub at the West Berkshire Community Hospital in which day case NHS skin cancer surgery is performed.  He also performs skin cancer and its reconstructive surgery in private hospitals in Oxford and Reading.  Sentinel Lymph Node Biopsy for Melanoma is exclusively performed at the John Radcliffe Hospital under a general anaesthetic as part of the treatment options available for Melanoma.

All major healthcare insurance companies recognise Titus Adams as a Plastic Surgeon with a specialist interest in this work.

Before and After Gallery

72 year old man with skin cancer to right upper ear 72 year old man with skin cancer to right upper ear, 6 weeks post op

62 year old man post-op skin cancer excision on left temple with advancement flap reconstruction

62 year old man with skin cancer on left temple pre-op 62 year old man post op skin cancer excision on left temple with advancement flap reconstruction

Breast lift – removal of 15 year old implants and auto augmentation mastopexy technique in 52 year old (before and 6 months after surgery)

74 year old pre-op excision of BCC right nose and Bilobed flap reconstruction 74 year old, 3 months post-op excision of BCC right nose and Bilobed flap reconstruction

74 year old, 3 months post-op excision of BCC right nose and Bilobed flap reconstruction

36 year old lady with BCC for excision and off-set flap reconstruction 36 year old lady post-op BCC excision with off-set flap reconstruction

36 year old lady, before and  post-op BCC excision with off-set flap reconstruction

Elderly lady with 20 year history of BCC left posterior shoulder, pre-op Elderly lady with 20 year history of BCC left posterior shoulder immediately, post-op

Elderly lady with 20 year history of BCC left posterior shoulder before and immediately after excision and reconstruction using a Latissimus Dorsi (LD) flap

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“Recommendation after recommendation has put Adams firmly on the Cotswolds map (he has clinics in Berkshire and Oxfordshire). It’s partly down to his nature (he’s a wonderful conversationalist and has charisma in spades), but also his manner, which is thoughtful and careful. His forte? Womanly tummies, with curves in the right places. New mummies in particular love the way he recontours the waistline and creates the illusion of a lightly toned abdomen.”

“Titus Adams makes light work of postpartum tummies, slimming the silhouette and nipping in waists by pulling the underlying muscles tight, like a corset. ‘Though it’s best to leave some fat behind,’ he says. ‘It allows fluid to drain from the body, rather than building up in the tissues’. The fat he does take, however, is useful if there’s need to plump a deflated cleavage. And, because he’s chatty and approachable, smoothing over even the most awkward of questions (like ‘how do you wear your undergarments?’ – crucial, as it ensures the best positioning of scars), you feel at ease. You trust him.”

“Adams listens carefully & closely. And his results are truly top notch whether he is tidying things up after some impressive weight loss or putting you back together after the last baby. The key phrase is ‘preservation of tissues’, to retain a natural appearance.”